Antibiotic treatment of group A streptococcal pharyngitis can relieve symptoms, limit transmission of infection, and prevent suppurative and nonsuppurative sequelae. Clinical findings may be unreliable, however, in establishing the diagnosis, and conventional throat cultures take overnight or longer to produce results. Rapid office tests for streptococcal pharyngitis can make the diagnosis in about 10 minutes. Since the previous Medical Letter article on this subject (Medical Letter, 27:49, 1985), many new tests have been marketed, including some that use new technologies.

In recent years, the availability of new types of lasers has improved the treatment of disfiguring cutaneous vascular abnormalities. Vascular lesions of the skin that can be treated with lasers include port-wine stains, telangiectases, and strawberry hemangiomas (RA Silverman, Pediatr Clin North Am, 38:811, Aug 1991).

A long-pulse ruby laser (EpiLaser), has been cleared by the FDA for use in "permanent hair reduction."

Phytoestrogens, plant compounds that are converted to estrogens in the gut, are widely promoted as "natural"substitutes for estrogen in hormone replacement therapy.

Recent studies suggest that timely use of automated external defibrillators operated by laypersons with minimal training can save lives. Purchase of these devices for public places or home use requires authorization from a physician.

CroFab, an antigen-binding-fragment (Fab) antivenom of ovine origin, has been approved by the FDA for treatment of North American rattlesnake envenomation.

Private cord blood banks continue to advertise their services to couples expecting a child. Cord blood can be stored safely for many years. Public cord blood banks accept collections only from affiliated hospitals (Medical Letter 2001; 43:84). Units are available for any patient; there is no guarantee that a particular donor's blood will be available if the donor or a family member needs a stem cell transplant. Many patients can find an unrelated match in a public cord blood bank, but members of minority ethnic groups are often more difficult to match (www.marrow.org). Private cord blood banks...

For patients with radicular pain unresponsive to conservative treatment after 1-2 months and no progressive neurologic deficit, epidural corticosteroid injections are often tried before surgical intervention.

The FDA has approved the Minimed 670G (Medtronic), a hybrid closed-loop insulin delivery system for use in patients ≥14 years old with type 1 diabetes. The system uses an algorithm to automatically adjust basal insulin doses based on readings from a continuous glucose monitor (CGM). It fully automates basal insulin delivery in "auto" mode, but is considered a "hybrid" system (not a true "artificial pancreas") because it requires some action by the patient. The 670G system is expected to become available in Spring 2017.

The FDA has amended its Emergency Use Authorizations (EUAs) for the mRNA COVID-19 vaccines manufactured by Pfizer/BioNTech (Comirnaty) and Moderna (Spikevax) to permit use of bivalent formulations of the products as a single booster dose in persons ≥12 years old (Pfizer) or ≥18 years old (Moderna) whose most recent COVID-19 vaccine dose was a monovalent product given ≥2 months previously as a booster or for completion of a primary series. The bivalent formulations are not authorized for primary immunization. Monovalent Pfizer and Moderna COVID-19 vaccines are no longer...